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A vertebral fracture in childhood is not a risk factor for disc degeneration but for Schmorl's nodes

Möller, Anders LU ; Maly, Pavel LU ; Besjakov, Jack LU ; Hasserius, Ralph LU ; Ohlin, Acke LU and Karlsson, Magnus LU (2007) In Spine 32(22). p.2487-2492
Abstract
Study Design. Observational cohort study. Objective. To evaluate by MRI whether a vertebral fracture during childhood is a risk factor for degeneration of adjacent discs. Summary of Background Data. Several studies infer that trauma is a major cause of disc degeneration. Only 1 study has by magnetic resonance imaging (MRI) evaluated disc degeneration in children with a former thoracic or lumbar vertebral fracture. That study reported a 50% prevalence of degenerative disc changes 4 years after the fracture. However, due to the sparse literature, it is still unclear whether a vertebral fracture in childhood represents a risk factor for disc degeneration in a long-term perspective. Method. Nine boys and 11 girls with a mean age of 12 years... (More)
Study Design. Observational cohort study. Objective. To evaluate by MRI whether a vertebral fracture during childhood is a risk factor for degeneration of adjacent discs. Summary of Background Data. Several studies infer that trauma is a major cause of disc degeneration. Only 1 study has by magnetic resonance imaging (MRI) evaluated disc degeneration in children with a former thoracic or lumbar vertebral fracture. That study reported a 50% prevalence of degenerative disc changes 4 years after the fracture. However, due to the sparse literature, it is still unclear whether a vertebral fracture in childhood represents a risk factor for disc degeneration in a long-term perspective. Method. Nine boys and 11 girls with a mean age of 12 years (range, 7-16 years) when sustaining a lumbar or thoracic vertebral fracture without neurologic deficits were examined at a mean of 40 years (range, 33-53 years) after the injury. Eighteen of the subjects had 1-column compression fractures, and 2 had Denis Type B burst fractures. All were mobilized without brace or surgery directly after being injured. A favorable long-term clinical and plain radiographic outcome has previously been reported for this cohort. In the present study, the intervertebral discs were evaluated with MRI by applying the Oner classification scheme. Degenerative disc changes were defined as loss of signal intensity on T2-weighted images with or without disc height reduction. Results. Degenerative changes were not more prevalent in discs adjacent to the previously fractured vertebrae than in discs at a distance from those segments. However, there were more Schmorl's nodes at the disc levels adjacent to the earlier fractures. Conclusion. Stable vertebral fractures in childhood with no neurologic deficits at injury do not render more degenerative changes than can be expected according to age, but they are associated with more Schmorl's nodes at adjacent disc levels. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
thoracic, lumbar, long-term, MRI, disc degeneration, children, fractures, nonoperative treatment, Schmorl's nodes
in
Spine
volume
32
issue
22
pages
2487 - 2492
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000250234100014
ISSN
0362-2436
language
English
LU publication?
yes
id
422f3bec-020d-49b3-93f9-a7e851e577c8 (old id 654226)
alternative location
http://www.spinejournal.com/pt/re/spine/abstract.00007632-200710150-00015.htm
date added to LUP
2007-12-18 11:26:26
date last changed
2016-04-16 03:01:27
@article{422f3bec-020d-49b3-93f9-a7e851e577c8,
  abstract     = {Study Design. Observational cohort study. Objective. To evaluate by MRI whether a vertebral fracture during childhood is a risk factor for degeneration of adjacent discs. Summary of Background Data. Several studies infer that trauma is a major cause of disc degeneration. Only 1 study has by magnetic resonance imaging (MRI) evaluated disc degeneration in children with a former thoracic or lumbar vertebral fracture. That study reported a 50% prevalence of degenerative disc changes 4 years after the fracture. However, due to the sparse literature, it is still unclear whether a vertebral fracture in childhood represents a risk factor for disc degeneration in a long-term perspective. Method. Nine boys and 11 girls with a mean age of 12 years (range, 7-16 years) when sustaining a lumbar or thoracic vertebral fracture without neurologic deficits were examined at a mean of 40 years (range, 33-53 years) after the injury. Eighteen of the subjects had 1-column compression fractures, and 2 had Denis Type B burst fractures. All were mobilized without brace or surgery directly after being injured. A favorable long-term clinical and plain radiographic outcome has previously been reported for this cohort. In the present study, the intervertebral discs were evaluated with MRI by applying the Oner classification scheme. Degenerative disc changes were defined as loss of signal intensity on T2-weighted images with or without disc height reduction. Results. Degenerative changes were not more prevalent in discs adjacent to the previously fractured vertebrae than in discs at a distance from those segments. However, there were more Schmorl's nodes at the disc levels adjacent to the earlier fractures. Conclusion. Stable vertebral fractures in childhood with no neurologic deficits at injury do not render more degenerative changes than can be expected according to age, but they are associated with more Schmorl's nodes at adjacent disc levels.},
  author       = {Möller, Anders and Maly, Pavel and Besjakov, Jack and Hasserius, Ralph and Ohlin, Acke and Karlsson, Magnus},
  issn         = {0362-2436},
  keyword      = {thoracic,lumbar,long-term,MRI,disc degeneration,children,fractures,nonoperative treatment,Schmorl's nodes},
  language     = {eng},
  number       = {22},
  pages        = {2487--2492},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Spine},
  title        = {A vertebral fracture in childhood is not a risk factor for disc degeneration but for Schmorl's nodes},
  volume       = {32},
  year         = {2007},
}